FAQ’s

Costs

How do I find out about the costs of a consultation/treatments?

Click here to be taken to the website of Mr Leatherbarrow’s clinic Face & Eye where there are full details ofcosts of consultations and treatments. Uninsured self-pay patients will always be provided with a written quote for the costs of surgery following a consultation. Mr Leatherbarrow is recognised by all private healthcare insurers and is fee assured.

Please note that Mr Leatherbarrow charges a higher consultation fee for patients who are seeking an opinion about the management of complications of cosmetic surgery undertaken elsewhere.

Blepharoplasty (Cosmetic Eyelid Surgery)

What are the reasons for having a blepharoplasty?

An upper eyelid blepharoplasty is performed for people who have droopy, overhanging eyelids that impair vision, cause frequent blinking and eye fatigue or look unsightly causing a cosmetic problem. It can be combined with ptosis surgery if there is an associated droop of the upper eyelid. Often an eyebrow ptosis (drooping of the eyebrows) contributes to the problem and may need to be addressed at the same time.

A lower eyelid blepharoplasty is also performed on people who have “puffy” lower eyelids or eye bags that may look unsightly and cause a cosmetic problem and affect self-confidence. An ophthalmic consultation with an oculoplastic specialist can provide a comprehensive assessment of your cosmetic eyelid problem, and a discussion of the available treatment options.

A lower lid blepharoplasty can often be undertaken via an incision on the inside of the lower eyelid, avoiding any visible scars (a scarless lower lid blepharoplasty). This is the procedure of choice for patients with lower lid ‘bags’ who do not have loose skin. This is referred to as a transconjunctival lower lid blepharoplasty with fat debulking, or more often, fat repositioning. This surgery can also be combined with microfat grafting of the cheek and the outer tear trough area to improve hollowing of these areas.

It is important that other potential medical problems are excluded as a possible underlying cause of the complaint e.g. an underactive thyroid gland can cause puffy eyelids.

Anti-wrinkle Injections

What are Anti-wrinkle injections?

These are injections of botulinum toxin, which reduce lines and wrinkles e.g. frown lines. This is achieved due to a temporary weakening of the muscles, which cause the lines and wrinkles.

Do the injections cause any pain?

The injections are performed quicky and cause minor discomfort. If you prefer, you can have anaesthetic cream applied to the areas of injection beforehand. This takes 15-30 minutes to take effect. Most patients, however, prefer to have the injections without any anaesthetic cream.

How good are the results?

The results are very good and quite reproducible. Generally, the initial effects are seen within 3 days of the treatment and the maximum effects are seen 7-10 days after the treatment. The effects last approximately 3-4 months. Regular maintenance treatment every 3-4 months helps to prevent recurrence of the lines/wrinkles.

Anti-wrinkle injections can also be used in conjunction with a dermal filler for deep lines although it is better to separate the treatment sessions by 2 weeks. The results of blepharoplasty surgery and brow lifts are also often enhanced by the use of anti-wrinkle injections given 2-3 weeks prior to surgery and continued long term.

Are anti wrinkle injections safe to use?

These injections have been used for a variety of cosmetic and non-cosmetic indications e.g. essential blepharospasm, for over 20 years and are considered a very safe treatment with a long safety track record.

Can there be side effects?

Complications in the hands of a trained and experienced practitioner are very rare and all precautions are taken to minimise any risks e.g. a temporary drooping of an upper eyelid. Some bruising may occur but the risk of this is minimised by applying firm pressure straight after the injections. It is important to let us know if you have a bleeding disorder, or if you are using anti- coagulants e.g. warfarin, or blood thinning medicines such as aspirin or arthritis medications such as ibuprofen. The use of aspirin or ibuprofen (and similar drugs) should be avoided for 2 weeks before these injections to minimize the risk of bruising. There have been no reported long-term ill effects from the use of botulinum toxin injections. We will provide you with a consent form which details all the potential risks of this treatment.

After Anti Wrinkle Injections:

Avoid any massage to the injected areas to prevent spread of the toxin to other adjacent muscles.

Patients can return to their normal activities straightaway but should avoid strenuous exercise for a few days or trauma to the injected areas.

How long have you been giving these injections?

Mr. Leatherbarrow is a fellowship trained ophthalmic plastic and cosmetic oculo-facial surgeon who has a vast amount of experience with the use of botulinum toxin injections. He was trained in the use of these injections during his fellowship at the University of Iowa Hospitals & Clinics, Iowa, USA in 1991-92. He has over 20 years of experience, has given thousands of such injections, and uses this treatment every week in his practice. Mr. Leatherbarrow also uses botulinum toxin to supplement the effects of operations on the eyelids and eyebrows.

I have heard that these injections are used for other reasons. What are these?

The injections can produce a brow lift or help to maintain a brow lift following surgery.

The injection of botulinum toxin into the area below the angle of the mouth can help to raise the smile.

The injection into the chin can help to improve dimpling/a horizontal line in this area.

A series of 4-5 injections along the jaw line can help to reduce early jowling by weakening the platysma muscle.

Very conservative injections along platysma bands can improve the appearance of the neck.

Injections into the upper lip can improve the appearance of vertical lip lines.

The injection into the skin reduces sweating in the treated area.

Injections into the lacrimal (tear) gland can reduce the production of tears in some patients.

Botulinum toxin injections given into the forehead/scalp can help patients with migraine unresponsive to other treatments.

The injections may improve the appearance of fresh skin scars by inhibiting fibroblast activitiy.

The injections have a good success rate when used for appropriate patients and when undertaken by a specialist oculoplastic surgeon.

What are the possible complications of tear trough injections?

Most complications of the treatment are minor and are amenable to successful treatment.Complications from tear trough injections include:

Infection

Bruising and swelling of the eyelids or the upper cheeks

Redness of the eyelids

Tenderness

Contour irregularities

Very rare: a localized allergic reaction in the form of firm swelling at the injection site. This has been seen in approx 1:10,000 patients, and may occur a few days up to several weeks after the injection. They may last a couple of weeks up to several months in rare instances. Prolonged firmness, abscess, formation, scarring, or a grey discolouration may occur in less than 1:15,000 cases, lasting several months.

Damage to the eye or eyesight including blindness from this procedure is an extremely remote risk in the hands of a specialist oculoplastic surgeon. All precautions are taken to minimize such a risk including the use of the TSK cannula wherever possible.

Blue discolouration over the injections can occur in some patients.

Further treatment. Further injections within the first 1-2 weeks to address any asymmetries or undercorrection may be required.

What is the post treatment care?

After the injections it is advisable to avoid rubbing the eyes, lifting weights or straining for a few days. Vigorous gym workouts should also be avoided for a few days.

Make up should be avoided for 48 hours.

It is helpful to apply Auriderm cream to the tear trough areas and to undertake gentle side to side massage twice a day for a week. This can be purchased from Face & Eye or online from the clinic’s online shop (www.faceandeyeshop.co.uk).

You are advised to sleep with the head raised approximately 30 degrees to help to minimize any eyelid swelling.

Contact lenses can still be worn following this type of treatment.

What are the costs of this treatment?

Click here for further information about the cost of tear trough rejuvenation injections.

Eye2C Optometry

What is Eye2C Optometry?

Eye2C Optometry is a new specialist optometry practice which was opened in November 2013 by Mr Leatherbarrow in conjunction with his optometry colleague, Mrs Rebecca Rietdyke (Becky), within his clinic Face & Eye in South Manchester. Becky was trained at Manchester Royal Eye Hospital and now offers a very personal and individual service for her patients.